Friday, December 29, 2006

The results are in....

We received Patton's results from his PennHip test from the University of Pennsylvania today. The numbers they came up with a little different then at VMTH, but still confirmed that the surgery was necessary. The ratio on his left hip was 0.81 (lower then what VMTH came up with, 0.92 was their measurement) We are almost positive that they(those doing the measurements) became flustered and flipped Patton's X-rays by accident. The vet doing the surgery was scoping the hip as they were doing the measurements and felt that they had indeed flipped them and continued. His right hip actually came in a little higher then at VMTH, they measured at 0.62 and Penn came up with 0.75.

So what does this all mean. The numbers (0.81 and 0.75) are a Distraction Index(DI) which measures the hip laxity of the joint(its looseness). So according to the PennHip test, there is an increasing risk of developing degenerative joint disease(or Hip Dysplasia) as the DI increases. So in simpler terms, there is a lower risk of degenerative joint disease the closer the DI is to 0.30, and a much higher risk as the number approaches 0.70 and beyond. So, looking at Patton's results, I am sure I will be hearing from VMTH after the new year about his right hip plus I know they wanted to X-ray his left hip to make sure it is healing properly. I believe he is to meet again with the physical therapist at the 4 week mark as well.

Thursday, December 28, 2006

Bad dog

Patton being shy?
Originally uploaded by sufras.
Now I know Patton is feeling much better and he about gave me a heart attack in the process. Yesterday as we were getting ready to go on our walk, we went out the front door and I must not have had a good hold on the leash. Patton bolted down the front steps and took off at a full run for about 50 yards until I could convince him to stop. Being a typical puppy, if you go after him he will continue to run away from you....a game. So after a few brief panicked moments, I ran into the house and grabbed the first thing I could get that I thought would bring him in. His pills of all things. He thinks they are treats. Then a car comes by, he is skittish around moving cars and I fear he is about to bolt again. Luckily, he stayed put. As I shake the pill bottle, telling him I have treats, I walk towards him. He finally begins to come towards me. As he takes the treat, I grab the leash. Adventure over hopefully with little damage. He is still not suppose to run. But at least we know he can. Bad dog.

Wednesday, December 27, 2006

Patton and his chew toy

Patton and his chew toy
Originally uploaded by sufras.
Sorry a few days has gone by since my last post. Been hard with the holidays and work. Hope everyone has had a wonderful Holiday season so far.

Patton continues to progress rapidly. As you can see from the picture there are no "marks" left from his surgery. The vets at VMTH did a great job. There are no scabs left so he no longer wears a E-collar at night or when we are gone. His hair continues to grow in rapidly(hard to tell from the picture, I know) We have also given him full reign over the downstairs. I am still not ready for him to tackle the stairs to go up with us at night, or head to the basement when the boys or I go down. I think it is better for him to stay in his kennel at night for now since the other hip will be done in January. I don't want to go through the him crying at night again when the time comes. We are still waiting to hear on the results of his PennHip test. His X-rays were sent to the University of Pennsylvania for final confirmation on his measurements.(Evidently, VMTH does this for all PennHip they do) Once they are back, we will most likely be scheduling the other hip.

Patton's energy level is completely where it was pre-surgery. We have stretched his walks to around the block and will be adding onto it as he is ready. We are met with stares and a few questions as to why he looks so funny. My little patchwork dog. Maybe I should tell people I really wanted a poodle? Anyway, he is all puppy still and wants to play with the rabbits in the yard, but we have to hold him back until he is completely healed. And he is having fun removing the decorations from our tree.

Each day he is putting more and more weight on the leg and we notice that his knee is more inline when he walks. He doesn't "bunny hop" when he walks like he did before the surgery either. All good signs.

Thursday, December 21, 2006

2 Weeks Post-OP

Hard to imagine that 2 weeks have passed. Patton had his staples and stitches taken out this afternoon. Amazingly he did this without being sedated. Way to go, Patton! Our regular vet was pleased with how he is healing and wasn't too concerned with Patton fighting the one range of motion exercise. Everything seemed to be going as planned. Our vet also told me that his hip was really a mess when they went in and scoped it. The condition of the joint was pretty bad. From the research that I have done and from what he said, I am surprised that they continued with the surgery. Though I am relieved that they did.

I can tell Patton is doing better by things he is doing around the house. He is his normal mischievous self. Twice today I have caught him with Christmas ornaments in his mouth that he as taken off the tree. He seems to think the soft fabric ornaments are his chew toys. He likes to bring them to me to show me what a good dog he is. (They are now higher on the tree) He is also trying to run after the boys when they walk away from him and he is back to wanting to rough house. All these activities are met with a harsh reprimand and a time out in his crate seems to calm him back down.

I took him on his first short walk. He seemed really happy and wanted to go further but I don't want to push him too hard at first.(plus it is really raw out today and I don't want to be out in it) But hopefully it will wear him out a little and keep him from undecorating the Christmas tree.

Sunday, December 17, 2006

Can't Keep a Good Dog Down

Playful Puppy
Originally uploaded by sufras.
Each day gets better and better. It is also getting harder to keep him from over extending himself. He just wants to play.

He is walking much better. His knee is slowly pulling in straight as he walks. It was turned to the outside as he walked before the operation. I have not given him Tramadol in a few days now, only the Rimadyl and Cosequin DS. He seems to being to be doing well without. Can't wait until Thursday when he gets his staples and stitches out. Hopefully, we'll get the all clear for him to begin short walks(5-10 minutes). Right now he is on the "got outside, do your thing and back inside walk". Not a lot of fun for him, too much to see and smell for a puppy.

Thursday, December 14, 2006

A week has passed

What a difference a week makes. Patton is doing great. I have begun letting him go up the outside stairs(3 steps) with out the sling and he does it quite well. Going down the steps still makes me a little nervous since he likes to jump down and out on the last one. The journey across the kitchen floor though I still use the sling since I am afraid of his leg sliding out from under him. As I watched him this morning, it dawned on me that when he sits he no longer extends out his left leg like he use to. He is now sitting like a "normal" dog. He always sat with a very "laid" back look. Now his left leg is tucked under like his right and he looks balanced.

I have also begun backing off on the Tramadol. The vet recommended 2-3 pills at a time every 8-12 hours, I only ever gave him 2 at a time every 8 hours and I have backed off to just two 1 pill doses a day. He doesn't appear to be in any discomfort. Though I am continuing the Rimadyl 2x a day until he gets his staples out in a week and I can get the ok from our family vet. The exercises prove a little more challenging. He doesn't mind too much the foot and ankle exercises but is fast to pull his leg away from you when you work the hip. Not too big of a deal, I do it when I can. He'll let you straighten the leg forward, then extend it back but then he pulls away. When he tucks up and contracts his leg he is basically finishing off the exercise for me. So one here and there gets it done.

I can tell he is feeling better because as I was doing the dishes I turned to catch him inching his way up on the sofa like he used to do. Kind of like "you don't really see me doing this so nothing to see here, move along." A sharp reminder from me and he slinked his way back onto the floor for his nap. Good dog.

Tuesday, December 12, 2006

5th Day Post Op

Patton continues to improve. He survived me going to work for the day. But it is proving to be difficult to convince him that he cannot not jump or run. On the whole we are able to keep him fairly calm but there are times he tries us. He also is calming down during the night as well. Just a little bit of howling on two separate occasions but nothing like in the past nights. I also removed his trans-dermal pain patch, which he was not too happy about. Think of a band-aid on your arm and having to remove it with out removing all your hair. OUCH! His hair is also beginning to regrow...yeah!!

Monday, December 11, 2006

Patton 4 Days Post Op

Patton 4 Days Post Op
Originally uploaded by sufras.
Patton is continuing to do well. The swelling of the surgery areas is going down and the incisions are looking nice. No redness or oozing. Each day his walking seems to be getting better as well. Not as unsteady as he was on Saturday. The picture in this post was taken this morning. At times he will put full weight on the foot, though not for long, most he holds it like in the picture("toe touching").

He has made no attempts on his incisions but if he is unsupervised for any length of time the E-collar or we have a blow up type of collar that he must wear. The problem with the inflatable collar is that he can still reach under his leg and down by his tail. So not a great solution for long periods of time. I did notice that one of the stitches on his rear has broken. I am almost positive that it was not him. I fear he may have caught it on a sharp edge in his cage. On our previous dog, when he had stitches, you could see that he had chewed the stitches. But Patton's wound is clean, no evidence of Patton licking it and the cut in the stitch is too perfect, like a scissor snipped it. Definitely need to keep an eye on it though.

Night is another story though. He is definitely NOT happy about being in his crate while we are all upstairs. He started howling at around midnight and my oldest son couldn't take it so he slept downstairs(or should I say attempted to sleep). We have reminded him that Patton needs to get used to the idea because he is just going to go through all this again next month. Breaks your heart to hear him crying and howling but he is not steady enough, or ready to make the journey upstairs. But if we give in now it will be worse later on.

Sunday, December 10, 2006

3 Days Post Op

After a slightly rough night, I am glad to say that Patton is doing very well. He whimpered a lot during the night and fell asleep in his crate, however, around 2 am he decided that he wanted to be upstairs with us like always. And he began to whimper, then full blown howling which lasted about 30-45 min before he settled back down again. Normally he would sleep up in our room but I am not ready(nor him physically) for him to attempt making a flight of stairs. The two steps into the house are enough of a challenge for me.

Hardly any whimpering today, and he is getting around much better. He spent a good portion of the afternoon playing with his toys(though from a lying position). His appetite is slowly picking back up again. Tonight, I was able to remove the bandage that you see in the pictures I posted yesterday. That incision has stopped weeping and looks good. Hopefully, all will be quiet tonight. As far as the exercises go, he doesn't mind most of them except the one that requires the leg to be straightened and then moved to the back(as if he was walking) and then contracted up to the hind quarter. That we shall work on, but the therapist said not to push him any further then he is ready for, each time should get a little better. As one that has had knee surgery, I know how he feels.

So baby steps for him for now but it can only get better.

Saturday, December 9, 2006

Patton Rehab pt 2

Patton Rehab pt 2
Originally uploaded by sufras.
Range of motion exercise to aid in recovery

Patton Rehab Excercise

Patton Rehab excerisice
Originally uploaded by sufras.
One of the rehab exercises to be done to keep the hip moving.

Patton 2 day post op

Patton 2 day post op
Originally uploaded by sufras.
Patton made his way home today. He is doing very well. My husband and oldest son went in to the VMTH this morning and met with a physical therapist who showed them how to get Patton in and out of the house(three steps in no matter where you enter the house could prove a challenge for him). They were also taught how to rehab Patton and get him moving again. They were shown a series of range of motion exercises to keep Patton's full range of motion. They were also shown massage techniques to keep the blood flowing to the wound areas to aid in healing. They also met with the Vet that did the surgery and walked them through the procedure. Since I was at work, they now need to fill me in.

He is getting around very well. According to my husband, Patton spent most of the afternoon asleep. Tonight he is a little more active. You can see two of his incisions(one is under the bandage on his rear end), the third is under his leg. He will get his staples out in about 2 weeks. He is doing a lot of whimpering, but as I said, he has always been very vocal. He still has a pain patch on his back and that will stay on until Dec 12 and he is on some pain medications, Tramadol and Rimadyl.

Friday, December 8, 2006

1 Day Post Op

Spoke with the vet on duty and the resident ; it was decided that Patton spend another night at the hospital. When they tried to get him to go outside he fights getting up but once he is up he is able to get around though with the aid of a sling and someone holding him up. He is being very vocal about the whole situation (he has always been very vocal about everything so nothing new there really) and we decided that he would be better off under their supervision for one more night. So tomorrow we will speak with a physical therapist for him and bring him home....hopefully. I miss my puppy.

Thursday, December 7, 2006

D-Day Pt2

Just spoke with the Vet that did the surgery. We are wondering if for some reason the numbers for Patton's hips are reversed. If the 0.9 was really his left hip and not the right. He is going to redo the measurements that radiology did to double check the results. Either way, the right hip is next regardless if it was 0.9 or 0.6. He stated again that the surgery went well even though while doing the arthroscope he did see some cartilage damage and the the ligament was slightly frayed but not enough to cancel the T.P.O.

At the time we spoke, he was by Patton's cage and he was sleeping comfortable, so that is great news.


Just received word from the resident at VMTH and the T.P.O. surgery went well. It went quickly and smoothly. Patton was out of surgery around 3:45pm CST but they were waiting to call since he was having a rough recovery. When he began to come around, he started thrashing, so they wanted to re-sedate him and place trans-dermal pain patches on him which take 12-24 hours to take affect. For now he is resting comfortably and they will administer pain medication through the night until the patches take affect.

The results of the PennHip test are in.....and to our shocking disbelief, the left hip in not as bad as feared but the right hip is worse. The left hip measured in at 0.6 and the right hip came in at a jaw dropping 0.9. So in 4 weeks we maybe going through this again for the right hip. I will have to wait for the vet to call a little later on tonight with his report.

So far, so good. We'll have to wait and see how he does through the night.

Wednesday, December 6, 2006

Patton Arrives

Today is the day that Patton goes to UW-Madison VMTH. Took us about an hour to get there and right before pulling into the parking lot, Patton decides he has had enough and throws up. Well they wanted his stomach empty and that is what they are getting. Props to my youngest son for attempting to clean it up and keep Patton from doing what dogs like to do.....inspect it(to put it nicely).

The VMTH is set up much like a hospital for people. Large reception area that just reminded me of a regular hospital. There were a few dogs in the waiting room that Patton was dying to meet. One was recovering from surgery to remove cancerous tumors, and another was awaiting treatment for cancer. It seemed like it was Lab and Golden Retriever day. They outnumbered the other dogs in the waiting room.

When Patton was finally called they do the usual, weight and routine questions. Patton weighed in at 35 kg(@77lbs). We spoke with a resident, who Patton decided he loved even when she was playing around with his hips. He didn't like it but he let her. After the normal checks,(teeth, heart and such) she left to consult with one of the main Vets(in our case on of the heads of the Dept). When they came back, Dr. Manley did the same checks as the resident and talked about our options.

Since we already had current X-rays they decided not to do any today. Tomorrow they would redo the PennHip test and do measurements to see exactly what was going on in Patton's hips. (They will also send these off to the University of Pennsylvania for their interpretation.) These measurement would be key in what they would be able to do for him. They will measure from the center of the ball of the femur to the center of the hip socket. Depending on the distance, that will decide our next step. If the distance is between 0.5 - 0.9 then the conditions are right for the Triple Pelvic Osteotomy(T.P.O.).....maybe. If he falls within this parameter they will then go in Arthroscopically look at his hip. This will also tell them how much arthritis is in the joint and the condition of his cartilage. At this time, they will then decide what they are going to do. If things fall like we think they will he will have the T.P.O surgery. Too much arthritis and the cartilage is in bad shape then they probably will not be able to operate and another option will have to be thought of. If his PennHip results are above 1 then Femoral Head Excision or total hip replacement may be an option. These are considered salvage procedures that would eliminate the diseased joint and attempt to replace it with a non-painful substitute. If his numbers fall below 0.5 then management of his weight, exercise and diet maybe be the route. This may also be the same game plan if his numbers should fall about 1. Dr. Manley mentioned that he has a dog that fell above the 1 range and through management the dog has lived a healthy and pain free life and is currently 7 years old. So that was reassuring.

So we play the waiting game for one more day. At any time during tomorrow if they feel that going on to the next step is NOT going to benefit Patton, all procedures will stop. If the PennHip numbers don't fall in the range, or if going in Arthroscopically shows that he is not a good candidate all bets are off and we will need to work a new plan.

We also talked about the T.P.O surgery, risks and his recovery. All the normal risks obviously, infection, problems with the anesthesia. He would have three cuts made to his pelvis therefore three incisions. One under his leg by his groin, one on top of his back and one along his leg, which would be the largest of the incisions. They would X-ray him again in 4 weeks since some dogs have been known to loosen the plates that are installed. At this time, if they need to do the right hip, this is when it would be done if his left hip has healed well enough to support him. He would also do a series of rehab in order to get his legs moving again and get him running.

So for now...we wait until tomorrow. Fingers crossed and breath held.

Monday, December 4, 2006

Countdown Begins

I went and picked up Patton's X-rays, copy of blood work done last week and a copy of his records from the Vets today. The hospital called to confirm our appointment for Wednesday at 10:30am. The countdown has begun. While at the Vets, I was told that our Vet would be attending Patton through his surgery on Thursday. At least he will see a face he knows, which is comforting. The hospital is about an hour away, so being there is a bit difficult for us between school and work. Phone calls to check on him will have to do.

Some have asked what is being done for Patton now for his hip. Before leaving on vacation the vets' had prescribed Rimadyl for pain management for him. To keep his joints healthy, they also prescribed Cosequin DS. We also decided that because he has almost tripled in size since August, and the current joint problem, we need to keep his weight manageable. It was decided to take him off the high caloric puppy food and move him on to adult dog food, but specific to joint therapy. So he was moved to Eukenuba Adult Plus with Glucosamine and Chondroitin Sulfate. Hopefully, all this and the surgery work for him. Fingers crossed.

So...2 days and counting.

Sunday, December 3, 2006

Patton's First Snow

Originally uploaded by sufras.
Here in Wisconsin we had our first significant snow on Friday. (Yes, I know we had snow in October and November, but really, did we have to shovel any of that. A half inch hardly can be considered "a snow".) Patton had a ball. Watching him play in the snow, throwing sticks and leaves that he finds into the air and then trying to find them again, it saddened me to think that this would be the only snow that he would be able to really play in this year. Once he has surgery he is down for the count for at least 4-6 weeks, no running, no jumping, and no playing in the snow.

Saturday, December 2, 2006

The Odyssey Begins

This blog is being created in the hopes that maybe Patton's odyssey will help other puppies and their owners through this scary time.

Patton was born April 28, 2006 at the local Humane Society. He joined our family on June 16, 2006, we fell in love with him immediately, all 12.5 lbs of him. He is a Yellow Lab/Golden Retriever mix and is the softest dog I have ever been around. At 3 months our vet suggested that we have him checked out for Hip Dysplasia. We agreed since he is a breed that is known for this disorder. Our Vet took X-rays and using the PennHip test we concluded that Patton was not at risk for Hip Dysplasia. Everything looked normal on his X-rays. Patton grew, and grew quickly. At 6 1/2 months he weighed in at 77 lbs and we began to notice that he was having trouble with his one hip. We thought maybe it was a soft tissue injury and treated it as such. Rest, and anti-inflammatory medication. He was going to be spending Thanksgiving at the Vet's office since we were going to be away. We all agreed that pending how he was doing they would take X-rays if he was still limping. The day before Thanksgiving came the dreaded phone 7 month old puppy had Hip Dysplasia and would need surgery.

When we returned from our vacation, I went and picked Patton up from the Vet and we discussed our options. He firmly believed that he was a candidate for a Triple Pelvic Osteotomy. Definite on the left hip and 50/50 on the right. Our Vet recommended that we make an appointment at The University of Wisconsin-Madison Veterinary Medical Teaching Hospital. An appointment was made that day for December 6.

So....our odyssey begins.